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Spotlight -

This Year In Medicine 2025

Opinion|Videos|April 23, 2025

Importance of Primary Care in Identification and Screening for Hypercortisolism

Author(s)Pamela Kushner, MD, FAAFP , John Anderson, MD, John Buse, MD, PhD

Experts discuss how the clinical presentation of hypercortisolism differs in the primary care vs specialist setting, highlighting earlier signs/symptoms vs overt disease, and review recent data on the prevalence of hypercortisolism, including its higher occurrence in patients with difficult-to-control diabetes, difficult-to-control hypertension, and cardiovascular disease.

Episodes in this series

EP. 1 Practical Strategies for Identifying and Screening for Hypercortisolism

EP. 1 Practical Strategies for Identifying and Screening for Hypercortisolism

EP. 2 Defining Hypercortisolism and Its Impact on Physical and Mental Health

EP. 2 Defining Hypercortisolism and Its Impact on Physical and Mental Health

EP. 3 Advances in the Understanding of Hypercortisolism

EP. 3 Advances in the Understanding of Hypercortisolism

EP. 4 Key Learnings From the CATALYST Study on Hypercortisolism Prevalence

EP. 4 Key Learnings From the CATALYST Study on Hypercortisolism Prevalence

EP. 5 Overcoming Inertia in Hypercortisolism Identification

EP. 5 Overcoming Inertia in Hypercortisolism Identification

EP. 6 Importance of Primary Care in Identification and Screening for Hypercortisolism

EP. 6 Importance of Primary Care in Identification and Screening for Hypercortisolism

EP. 7 Who to Screen for Hypercortisolism

EP. 7 Who to Screen for Hypercortisolism

EP. 8 Dexamethasone Suppression to Identify Hypercortisolism

EP. 8 Dexamethasone Suppression to Identify Hypercortisolism

EP. 9 Effect of Hypercortisolism on Cardiovascular and Diabetes Care

EP. 9 Effect of Hypercortisolism on Cardiovascular and Diabetes Care

EP. 10 Importance of Multispecialty Communication in Hypercortisolism Management and Referrals

EP. 10 Importance of Multispecialty Communication in Hypercortisolism Management and Referrals

EP. 11 Addressing Potential Barriers to Implementing Hypercortisolism Screening in Practice

EP. 11 Addressing Potential Barriers to Implementing Hypercortisolism Screening in Practice

Video content above is prompted by the following:

How would the clinical presentation of hypercortisolism differ in the primary care vs specialist setting?
Earlier signs/symptoms vs overt disease
The prevalence of hypercortisolism in certain at-risk patients is higher than previously thought. Can you discuss some of the recent data on hypercortisolism prevalence?
Prevalence of hypercortisolism in patients with difficult-to-control diabetes was 24%.
Prevalence of hypercortisolism in patients with difficult-to-control diabetes and difficult-to-control hypertension was 40%.
Patients with cardiovascular disease had a higher prevalence of hypercortisolism than those without (33.3% vs 20.9%).

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